IBTRD1 ;ALB/AAS - CLAIMS TRACKING - APPEAL/DENIAL ACTIONS ; 10-AUG-93 ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94 ;;Per VHA Directive 10-93-142, this routine should not be modified. ; % G EN^IBTRD ; AA ; -- Add Appeal entry N X,Y,I,J,DA,DR,DIC,DIE,DR,DD,DO,IBQUIT,IBTRCDT,IBXX,VALMY,IBTRN,IBTRC D EN^VALM2($G(XQORNOD(0))) I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX!$D(DIRUT) D .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2) .; -- must be a denial or a penalty .S IBDENIAL=$O(^IBE(356.7,"ACODE",20,0)) .S IBPENAL=$O(^IBE(356.7,"ACODE",30,0)) .I '$D(^IBT(356.2,"ACT",IBDENIAL,IBTRC))&('$D(^IBT(356.2,"ACT",IBPENAL,IBTRC))) W !!,"You can only appeal a denial or an penalty." D PAUSE^VALM1 Q .D AA1 D BLD^IBTRD S VALMBCK="R" Q ; AA1 ; -- select date N DIR,IBTRCDT S DIR(0)="356.2,.01",DIR("A")="Select Appeal Date",DIR("B")="NOW" D ^DIR K DIR I $D(DIRUT)!($E(+Y,1,7)'?7N) G AA1Q S IBTRCDT=+Y ; ; -- if not tracking id allow selecting S IBTRDD=$G(^IBT(356.2,+IBTRC,0)) S IBTRN=$P(IBTRDD,"^",2) S DFN=$P(IBTRDD,"^",5) S IBPARNT=IBTRC S IBCDFN=$P($G(^IBT(356.2,IBTRC,1)),"^",5) ; ; -- add entry S IBTCOD=$S('$D(^IBT(356.2,"AP",IBTRC)):60,1:65) D COM^IBTUTL3(IBTRCDT,$G(IBTRN),IBTCOD,$G(IBTRV)) ; -- ibtrc now entry of new appeal ; ; -- edit based on S DIE="^IBT(356.2,",DA=IBTRC L +^IBT(356.2,+IBTRC):5 I '$T D LOCKED^IBTRCD1 G AA1Q S DR="[IBT ADD APPEAL]" ;S DR=".18////"_IBPARNT_";1.05////"_IBCDFN_";.04;.23;.1;.25;11;.24;.19" D ^DIE K DIE L -^IBT(356.2,+IBTRC) AA1Q Q ; DT ; -- Delete Insurance Action entry I '$D(^XUSEC("IB CLAIMS SUPERVISOR",DUZ)) D SORRY^IBTRE1 G DTQ D EN^VALM2($G(XQORNOD(0))) N I,J,IBXX,DIR,DIRUT,IBTRN I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX!$D(DIRUT) D .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2),IBTRN=$P($G(^IBT(356.2,+IBTRC,0)),"^",2) .I $O(^IBT(356.2,"AP",IBTRC,0)) W !,"Must first delete appeals associate* d with Denials" D PAUSE^VALM1 Q .; .W ! S DIR(0)="Y",DIR("B")="NO",DIR("A")="Are You Sure you want to delete entry #"_IBXX .D ^DIR I Y'=1 W !,"Entry #",IBXX," not Deleted!" Q .D DP1^IBTRC1 .Q DTQ D BLD^IBTRD S VALMBCK="R" Q ; QE ; -- Quick edit Review entry D EN^VALM2($G(XQORNOD(0))) N I,J,IBXX,IBTRN,IBTRC I $D(VALMY) S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2),IBTRN=$P($G(^IBT(356.2,+IBTRC,0)),"^",2) .D QE1 QEQ S VALMBCK="R" D BLD^IBTRD Q ; QE1 N X,Y,DA,DR,DIC,DIE D EDIT^IBTRCD1("[IBT QUICK EDIT]",1) Q ; NX(IBTMPNM) ; -- Go to next template ; -- Input template name N I,J,IBXXC,VALMY,IBTRN D EN^VALM2($G(XQORNOD(0))) I $D(VALMY) S IBXXC=0 F S IBXXC=$O(VALMY(IBXXC)) Q:'IBXXC D .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXXC,0)))),"^",2),IBTRN=$P($G(^IBT(356.2,+IBTRC,0)),"^",2) .S:'$D(DFN) DFN=$P($G(^IBT(356.2,+IBTRC,0)),"^",5) .S:'$D(IBCNS) IBCNS=$P($G(^IBT(356.2,+IBTRC,0)),"^",8) .D EN^VALM(IBTMPNM) .K IBAMT,IBAPR,IBADG,IBDA,IBDGCR,IBDGCRU1,IBDV,IBETYP,IBETYPD,IBI,IBICD,IBLCNT,IBSEL,IBT,IBTEXT,IBTNOD,IBTSAV,VAUTD .K IBAPEAL,IBCDFN,IBCNT,IBDEN,IBDENIAL,IBDENIAL,IBPARNT,IBPEN,IBPENAL,IBTCOD,IBTRDD,IBTRSV,IBTYPE,VAINDT,VA .D KVAR^VADPT .Q I '$D(IBFASTXT) D BLD^IBTRD S VALMBCK="R" Q ; EDIT(IBTEMP) ; -- Edit entries N VALMY D EN^VALM2($G(XQORNOD(0))) N I,J,IBXX I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2) .W !!,"Editing Entry #",IBXX,! .D EDIT^IBTRCD1(IBTEMP,1) S VALMBCK="R" D BLD^IBTRD Q SHOWSC ; -- show sc conditions N VALMY D FULL^VALM1 I IBTRD["DPT",$D(DFN) D SHOWSC^IBTRC1 G SHOWQ ; D EN^VALM2($G(XQORNOD(0))) N I,J,IBXX,DFN,IBTRC I $D(VALMY) D FULL^VALM1 S IBXX=0 F S IBXX=$O(VALMY(IBXX)) Q:'IBXX D .S IBTRC=$P($G(^TMP("IBTRDDX",$J,+$O(^TMP("IBTRD",$J,"IDX",IBXX,0)))),"^",2) .S DFN=$P($G(^IBT(356.2,+IBTRC,0)),"^",5) .D SHOWSC^IBTRC1 SHOWQ S VALMBCK="R" Q